logical integrations, inc. tobacco control training …...racial equity statement drafted again,...
TRANSCRIPT
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WELCOME
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Tobacco Control Training Collaborative
Health Equity: Clarifying Our Language and Reflecting on Our Practice
Tamatha Thomas-Haase, MPA Webinar Facilitator
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Housekeeping
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Learning Objectives
After attending this webinar, participants will know:
Specific tactics for incorporating health equity into five
foundational elements of public health practice (building
organizational capacity; engaging community; developing
partnerships and coalitions; evaluation; and identifying and
analyzing health disparities)
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Today’s Featured Speakers
Pamela Diggs, Youth Empowered Solutions (YES!)
Jen Keith, Public Health Management Corporation
Michael Scott, National African American Tobacco
Prevention Network
LaTisha Marshall, Program Services Branch, CDC-OSH
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What is health equity?
“Health equity means that everyone has a fair and
just opportunity to be healthier. This requires
removing obstacles to health such as poverty,
discrimination, and deep power imbalances, and
their consequences, including lack of access to
good jobs with fair pay, quality education and
housing, safe environments, and health care.”Robert Wood Johnson Foundation; Author(s): Braveman P, Arkin E, Orleans T, Proctor D, and Plough A; May 1, 2017
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What does it mean to promote health equity? systematically address power imbalances, racism, and other
forms of oppression
transform the way we work internally, with communities, and
alongside other government agencies
apply a health equity lens to organizational capacity; engaging
community; developing partnerships; evaluation; identifying
and analyzing disparities
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Building Organizational Capacity
Walk It Like We Talk It
Building Organizational Capacity for Health Equity
Today’s Discussion
Background
Racial Equity Process
Outcomes
Recommendations / Best Practices
#YES4Change
Background
What’s that you say?
What we know:
Young people under the age
of 18 make up a quarter of
the U.S. population, yet their
potential as a generation is
being systematically ignored.
#YES4Change
YES! Youth Empowerment Model®
• Skill Development
• Critical Awareness
• Opportunities
#YES4Change
YES! is committed to creating a society
where empowered youth leaders work
alongside adults to create just, equitable
and thriving communities.
The Curb-Cut Effect
By the end of the
decade, the majority
of Americans under
age 18 will be people
of color.
#YES4Change
Youth have always been at the forefront of changeLittle Rock Nine
#YES4Change
Current youth-led movementsTobacco-Free Schools, Smoke-Free Restaurants & Bars in North Carolina
#YES4Change
Current youth-led movementsInternational Indigenous Youth Council
#YES4Change
PHOTO: The International Indigenous Youth Council in December 2016
Diversity, Inclusion, Equity Matters“This Is America” “Walk It Talk It”
#YES4Change
Racial Equity Process
What Is Racial Equity?Explicit, not exclusive
A racially equitable society would be one in which there are improved outcomes for all and the distribution of resources, opportunities, and burdens was not determined, predictable, or disproportionate by race.
#YES4Change
#YES4Change
A Seat at the Table
Equity is a proactive, strategic
approach that accounts for
differences in opportunities and
burdens, as well as needs, in
order to achieve true equality for
all. – OpenSource Leadership
Strategies*
EQUITY VS EQUALITY
1. Our mission depends on it.
2. Power is not balanced.
3. Economic factors are correlated to race because of structural racism.
4. Economic factors do not explain all inequities.
5. Racial equity facilitates youth equity.
6. Intersectionality.
7. Youth demand it.
8. Youth are experiencing “death by racism”
9. It is urgent.
10. To enhance our model.
10 Reasons Why
#YES4Change
YOUTH EMPOWERMENT DOESN’T WORK WITHOUT RACIAL EQUITY
#YES4Change
YES!’s Racial Equity JourneyContinues…
#YES4Change
Solid Foundation
Hiring Practices
Formation of Equity Leadership Team
Training & Assessment($15,000 - 9 mo. contract withOpenSource Leadership Strategies)
Results Framework
Repeat…
Racial Equity Statement DraftedAgain, explicit, not exclusive
YES! is committed to creating community change through the lens of social justice by applying an explicit racial equity framework. We believe that structural racism is the underlying root cause of inequities we seek to address across many different sectors, including health…
#YES4Change
Outcomes
A lot has changed…Walking the Talk
Racial Equity statement in
progress New contract language
Facilitation notes for external trainings
#YES4Change
Pre-memo implemented for trainings Consulting
tools being updated
New YES! Network partner
requirements
More Walking the Talk
#YES4Change
Recommendations / Best Practices
Embed Racial Equity Into the Organizational DNA
#YES4Change
1. Opportunity to Strengthen Partnerships e.g. – Increase partnerships with organizations led by people of color; Caucusing by racial identity
2. Opportunity to Align External Communication and Internal Culture e.g. – Rewrite mission, vision, values, internal policies; Respond to public events; Create an Equity Leadership Team
3. Opportunity to Negotiate Power e.g. – Clarify roles; Try out shared leadership models; Continually ask, “how is structural racism operating here?,” which inevitably allows for the question of how is structural ageism, sexism, ableism, heterosexism, etc. operating here?
4. Opportunity to Further Promote Youth Empowermente.g. – Embed racial equity into ALL trainings; Develop a tool to assess the intersection of equity and your work; Understand the organization itself is a target of change.
#YES4Change
Contact Info:
Pam Diggs, MPH, Director of Programs & Racial Equity [email protected]
Human progress is neither automatic nor
inevitable. Even a superficial look at history
reveals that no social advance rolls in on the
wheels inevitability. Every step towards the
goal of justice requires sacrifice, suffering, and
struggle; the tireless exertions and passionate
concern of dedicated individuals. Without
persistent effort, time itself becomes an ally of
the insurgent and primitive forces of irrational
emotionalism and social destruction. This is no
time for apathy or complacency. This is a time
for vigorous and positive action.”
- Dr. Martin Luther King, Jr. in Stride Toward
Freedom the Montgomery Story - Chapter XI
Where Do We Go From Here
WHERE DO WE GO FROM HERE…
Question
&
Answer
#YES4Change
Thank you!!!
Question
&
Answer
#YES4Change
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Engaging Community Members
Promoting Equity Requires Playing with Others
Health Equity: Clarifying Our Language and Reflecting on Our Practice
June 2018
Social determinants of health are…
…conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.”
- HealthyPeople2020www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Social Determinants
of Health
Neighborhood & Built
Environment
Health & Health Care
Social & Community
ContextEducation
Economic Stability
PA uses CDC’s Evaluation Framework…
https://www.cdc.gov/eval/framework/index.htm
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
healthequity.globalpolicysolutions.org/about-health-equity/
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
healthequity.globalpolicysolutions.org/about-health-equity/
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
Conduct focus groups with incarcerated women who utilized the PA Free Quitline
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
healthequity.globalpolicysolutions.org/about-health-equity/
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
Sponsor LGBT Health Conference to discuss tobacco control and so much more…
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
healthequity.globalpolicysolutions.org/about-health-equity/
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
Rally a PA State Strategy Session on tobacco-free recovery
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
healthequity.globalpolicysolutions.org/about-health-equity/
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
Partner for Day at the Capitol and youth capacity building
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
healthequity.globalpolicysolutions.org/about-health-equity/
Health Equity requires
1) Focusing on needs of marginalized community members
2) Recognizing the intersection of issues
3) Establishing and maintaining authentic relationships with community members
4) Recognizing and leveraging community power
5) Working with community members across sectors, issues, and social groups
Prepare a strategic plan to address health disparities with a dedicated group
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Developing Partnerships and Coalitions
Stone Soup
Developing coalitions/partnerships is like the old fable…….
Tuckman’s Team Development Model
• Community Input• Relationship Building• Legislative Champions
• Media Campaign• Strong Partnerships
How Chicago Pulled It Off
Engage from multiple sectors
• Tobacco Control ( Menthol, Predatory Marketing) • Cancer Disparities (Screening, Prevention, Cancer
Survivorship,) • Cultural Competency• Community Engagement• Coalition Building• Successful Marketing to the African American
Community • Youth Empowerment• Health Equity• Menthol• Fundraising and Grant writing • Establishing a 501 (c)(3) Organization
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Equity in Evaluation
Addressing Health Equity in Evaluation
LATISHA MARSHALL , DRPH, MPH
HEALTH SCIENTIST/PUBLIC HEALTH ADVISOR
OFFICE ON SMOKING AND HEALTH
606/11/2018
Designing Evaluations to Promote Health Equity▪ Designed to understand what works, for whom, under what conditions
▪ Reveals whether health inequities have decreased, increased, or stay the same
▪ It is important for programs to include questions in evaluation plans about how activities affect disparities (intended and unintended effects)
6/11/2018 61
CDC’s Framework for Program Evaluation
6/11/2018 62
Engaging Stakeholders▪ Members who are the intended users of your program
▪ Partners working with population groups experiencing health inequities
▪ Partners from multiple fields and sectors that have a role in advancing health equity
▪ Others who have a stake or vested interest in the evaluation, and interest in program implementation
▪ Engage throughout all steps of the evaluation
6/11/2018 63
Describe the Program
▪ Shared understanding of the program
▪ Develop logic model that includes health equity activities and goals
▪ Document health equity-related process activities and outcome goals
6/11/2018 64
Example of Integrating Health Equity Goals into Evaluation
6/11/2018 65
Focus the Evaluation Design▪ Incorporate health equity goals into evaluation questions
▪ Evaluation questions may help you determine what has worked for whom and under what conditions
▪ Consider indicators of success at all stages of the logic model
▪ Include process and outcome evaluation to understand the effect on health inequities
6/11/2018 66
Gather Credible Evidence▪ Identify appropriate variables (e.g. income, race, zip code, etc. ) and sampling plans needed to assess differential effects of interventions
▪ Use culturally appropriate tools and methodologies
▪ Use multiple approaches to understand intervention effect on health inequity
▪ Approaches include focus groups, talking circles, interviews, surveys
▪ Include monitoring and assessment components
6/11/2018 67
Justify Conclusions▪ Analyze and interpret data using health equity lens
▪ Engage stakeholders in interpreting and summarizing conclusions
6/11/2018 68
Use and Share Lessons Learned▪ Increase awareness among community members and stakeholders
▪ Contribute to the evidence base by sharing findings
▪ Influence program improvement
6/11/2018 69
When designing an evaluation, it is important to…▪ Actively engage members of the community being served as stakeholders
▪ Develop a conceptual model that includes health equity activities, outcomes, and goals
▪ Incorporate health equity into evaluation questions and design
▪ Use culturally appropriate tools and methodologies
▪ Use process and outcome evaluation to understand the effect of health inequities
▪ Widely disseminate the results of equity-oriented evaluations
6/11/2018 70
References▪ Centers for Disease Control and Prevention – Division of Community Health. A Practitioner’s Guide for Advancing Health Equity: Community Strategies for Preventing Chronic Disease. Atlanta, GA: US Department of Health and Human Services; 2013.
▪ Developing an Effective Evaluation Plan. Atlanta, Georgia: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Division of Nutrition, Physical Activity, and Obesity, 2011.
▪ Division of Heart Disease and Stroke. What Is the Dual Approach? https://www.cdc.gov/dhdsp/docs/DHDSP-Dual-Approach.pdf
▪ Centers for Disease Control and Prevention. Office on Smoking and Health. Best Practices User Guide: Health Equity in Tobacco Preventions and Control. Atlanta: U.S. Department of Health and Human Services, 2015.
6/11/2018 71
6/11/2018 72
For more information:
LaTisha Marshall DrPH, MPH
The findings and conclusions in this report are those of the authors and do not necessarily
represent the official position of the Centers for Disease Control and Prevention.
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Identifying and Analyzing Disparities
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◦ Examines current evidence surrounding
tobacco-related health disparities
◦ Uses a socioecological approach to describe:
differences between population groups
across the tobacco use continuum
differences in access to tobacco dependence
treatment among minority racial/ethnic and
low socioeconomic status groups
◦ Recognizes intersectionality!
◦ Draws five broad conclusions
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Important Health Equity Resources
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